| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1001 LAKESIDE AVE E STE 1200 CLEVELAND, OH 441141172 | UNITEDHEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 2.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.30% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $156K |
| USI INSURANCE SERVICES LLC EIN 13-3771734 BROKER | Other commissions Service code 55 | 1001 LAKESIDE AVE E STE 1200 CLEVELAND, OH 441141172 | $59K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 472 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 473 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 472 | $662K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 472 | $662K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 276 | $24K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 276 | $24K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 101 | $23K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 472 | $662K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 472 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.